some may require weeks or even months. It depends on
the severity of the brain injury and if the patient is having
any complications. This can be very hard and difficult time
for the family and friends. Ask the doctors and nurses
any questions you may have. Write the questions down so
you don’t forget. If you don’t understand what the doctors
or nurses are telling you, ask again. You will want to stay
informed and understand what it happening.
When the patient’s condition improves, they will either go
home or to a rehabilitation facility. The rehabilitation facility
re-teaches the patient activities of daily living (ADL’s). Some
of these activities include, how to feed themselves, how to
dress, how to walk, and talk. The rehabilitation facility will
prepare the patient and family for the rest of their lives.
Keep in mind; it takes time to arrange for admission into
a rehabilitation facility. The doctors, nurses, and social
worker will work on this early in the patients’ hospital
stay, sometimes while the patient is still in ICU. This may
seem early to you but it takes time and they want to be sure
everything is ready to go when the patient is discharged.
This article was revised from the “ER to ICU”
article in the BIAK Resource Journal by Don Kautz,
CCRN; Linda Hotzclaw, CCRN Angelica Ford, BSN;
Kemberly Shuster, BSN.
Appendix A:
Glasgow Coma Score:
WAIVER CASE MANAGEMENT
RiverValley Behavioral Health Waiver Case Managers
are highly knowledgeable and understand the
collabora
individual and facilitate the evidenced-
of Person-
www.rvbh.com
1 2 3 4 5 6
EYES Does not
open eyes
Opens eyes in
response to
painful stimuli
Opens eyes in
response to voice
Opens eyes
spontaneously
N/A N/A
VERBAL Makes no
sounds
Incomprehensible
sounds
Utters inappropriate
words
Confused;
disoriented
Oriented; converses
normally
N/A
MOTOR Makes no
movements
Extension to
painful stimuli
Abnormal f lexion to
painful stimuli
Flexion/
withdrawal to
painful stimuli
Localizes painful
stimuli
Obeys
commands
The lowest score is a GCS of 3 = deep coma or brain death
The highest score is a GCS of 15 = fully awake person
2020-2022 BIAK Resource Journal 11
/www.rvbh.com